Critical emergency medicine and the resuscitative care unit

Abstract

Critical emergency medicine is the medical field concerned with management of critically ill patients in the emergency department (ED). Increased ED stay due to intensive care unit (ICU) overcrowding has a negative impact on patient care and outcome. It has been proposed that implementation of critical care services in the ED can negate this effect. Two main Critical Emergency Medicine models have been proposed, the “resource intensivist” and “ED-ICU” models. The resource intensivist model is based on constant presence of an intensivist in the traditional ED setting, while the ED-ICU model encompasses the notion of a separate ED-based unit, with monitoring and therapeutic capabilities similar to those of an ICU. Critical emergency medicine has the potential to improve patient care and outcome; however, establishment of evidence-based protocols and a multidisciplinary approach in patient management are of major importance.

Value of Intensive Nursing Detail Management in Intensive Care Unit Nursing

“…Intensive care units (ICUs) [ 1 ] provide optimal protection for critically ill patients in terms of medical resources and technology [ 2 ] and deliver the finest care, comprehensive treatment, medical and nursing integration, and early postoperative rehabilitation to obtain positive treatment outcomes [ 3 , 4 ]. ICU is a form of medical organization and management that emerges with the joint development of nursing and rehabilitation, the advent of new medical equipment, and the improvement of hospital management systems [ 5 ].…”

Effect of Early Low-Calorie Enteral Nutrition Support in Critically Ill Patients: A Systematic Review and Meta-analysis

“…Early enteral nutrition assistance is essential to enhance patients' nutritional status. The optimum timing of enteral feeding for critically sick patients must also be decided throughout the course of early enteral nutrition [ 4 ]. In patients with active upper gastrointestinal bleeding, for example, enteral nutrition should be postponed; once the bleeding ceases, enteral nutrition therapy may be started [ 5 ].…”

The impact of emergency department length of stay on the outcomes of trauma patients requiring hospitalization: a retrospective observational study

“…[3,6,20] Also, a well-trained EMS team could rely on the initial vitals at the scene, which could help in the timely triage of patients to either dedicated trauma bays or other areas of the ED. [21] Notably, the HTC has six dedicated trauma bays run by trauma surgeons with easy access to ICUs and operating rooms placed within proximity, which could facilitate early appropriate resuscitation and emergency care.…”

“…Patients with shorter EDLOS (<4 h) were found to have significantly higher ISS 14 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26), head AIS 4 (3-5), chest AIS 3 (2-3), abdominal AIS 3 (2-4), pelvis AIS 2 (2-2) and lower mean TRISS (0.89±0.20) and RTS scores (6.67±1.71) than the other groups with longer EDLOS. The frequency of head, chest and abdominal injuries was also significantly higher in patients with shorter EDLOS (<4 h), while spinal (>24 h) and lower extremity injuries (4-12 h) were more common in the long EDLOS group.…”